Dark as Daylight Ch. 17

"I have given your man all my information. Phone numbers, home and business addresses. From this day forward I will be an advocate for my patients, instead of working like the Canadian government pays me to work. I would like to work the way the American doctors work, and your medical system, but up here they don't make it worth our while. They pay us less than they pay sanitation workers. Most of us, me included, feel why should we work hard, and be sued by a patient who doesn't appreciate what I do. I don't get paid properly for my 19 years of schooling, and three years of residency, where I barely make enough to pay the rent and food. When I finally became a fully qualified Doctor, here in Vancouver I make $23 a month less than a sanitation worker in Québec city. They are unionized, and doctors are not allowed to unionize because of our healthcare law.

I'm going to begin working like the doctor I wanted to be as a child. All I wanted to do was help people. From now on Colonel, I'm going to be the doctor I always wanted to be."

"That'll be fine Doctor Coppens. Don't let yourself or me down."

"Here's your orderly. Off you go to get your arterial scan. I will see you in the OR."

****************************

It took Doctor Llewellyn nearly 90 minutes to remove a 6-inch section of a vein from the Small Saphenous (Superficial) Vein in preparation to replace a portion of the Posterior Tibial Artery, in Colonel Canyon's left leg. He reattached the open end of the Saphenous Vein to the Medial Epicondyle Vein to keep the circulatory system working properly. From Doctor Llewellyn's point of view this portion of the procedure was successful, because there was no leakage where the two veins attached.

The portion of the vein he removed was cleaned both outside, and inside to reduce the risk of infection, as they prepared it for resection to Colonel Canyon's artery. This part of the procedure had to be quick. You never want to starve any part of the body from oxygenated blood. In this case, it would be Colonel Canyon's foot that would suffer. Doctor Rosenstein didn't want his patient to lose the use of that limb because of one bad stitch.

Llewellyn was standing by the Colonel's leg, staring at the venal scans, and x-rays, squeezing and otherwise playing with a rubber ball, between his hands. The Colonel was only under a localized anesthetic, and was watching the doctor closely. After many moments, he decided he waited long enough.

"Do you have a problem with my leg Doctor?"

"Couldn't you have crushed the artery in a better position than you did, Mr. Canyon?"

"No, doctor, I couldn't. You see, when I had breakfast with God this morning, I was given a choice, either I could break the bone and crush the artery right there, or, as a second choice, I could break my neck. I chose not to break my neck.

Is repairing the Posterior Tibial Artery in that position beyond your capability? If it is, I will fly to Seattle, find a better hospital, and a better Doctor. It will have you spared the embarrassment of seeing your name in the newspapers advising everyone that you were unable to attach a piece of artery to another piece of artery, because it was above your skill level? Is it that complicated a procedure?"

No one had spoken to him like that since he became chief resident.

"Mr. Canyon, your leg is my responsibility. I don't want a bad result so you wind up suing me in three months for the loss of the use of your foot."

"Doctor, I have more money than I can spend in 10 lifetimes. I could buy this hospital and fire everyone who was employed by it. I don't care about you being the chief resident, or your boss. All I care about is my leg. Can you repair it properly or not? You have 60 seconds to answer me, before I have a nurse go outside and get my second in command to take me out of here."

"Mr. Canyon, this is not the Army. This is a hospital. Things don't work that way."

"Would you like to see things work that way Doctor? You have 50 seconds remaining to answer my question, or I am out of here."

"Nurse, could you hand me a whiteboard and a pen, please."

"Yes Doctor. Here you are."

"Thank you. Mr. Canyon, here is the problem. You managed to crush the Posterior Tibial Artery, which runs down the inside of the large bone in your leg, the tibia. The area that is crushed is right by the break, and it is sitting by a piece of bone that the orthopedist may or may not decide to take off. I'm thinking of rerouting the artery this way to give the orthopedist enough room to make his decision, and make his repairs. You are going to have a metal sleeve on that leg, somewhere between 8 to 12 inches long. It will be glued in place, and held steady by eight to 10 screws. I don't want to make the artery to tight for him to work around, or to loose, which would give it a chance to rub against the metal and cause it to wear over time, and begin to leak."

"Is that the whole problem Doctor?"

"Yes, it is."

"Doctor Coppens can you hear me?"

"I've read your mind Colonel, and I'm on the way."

"What are you going to do Doctor?"

"I'm going to get you an orthopedic surgeon."

"That is an excellent idea."

"He can't get the orthopedic surgeon; I'm not finished with you yet."

"Doctor, if all you had to do was fix that artery against a solid bone, how long would it take?"

"It would take 40 minutes to do the resection, and another 20 minutes to sew you up properly."

"Doctor Llewellyn, you are going to take a break of approximately one hour. When you return, you will have a solid bone, against which you can judge the way you want to route artery, and how much space to leave. Your problem, and my problem will be solved."

"That's not how we work up here. It may be the way you work in the US, but we have a different system here, in Canada."

"How is your system working, Doctor?"

"It's not working as well as it should."

"Nurse."

"Yes Mr. Canyon."

"There is a man in the surgical waiting room. You can't mistake him for anyone else. He is in his 60s, and could pass for a 30-year-old. His name is Paul. He is my next of kin. Tell him to call my lawyer. I want him here, in Vancouver, tomorrow. If he says he can't be here, tell Paul to fire him, and to call 'The Private.' Tell him I want to buy a hospital, and I need an attorney that knows how to do it. He will know what to do."

"Why do I have a feeling you're not joking, Mr. Canyon?"

"Because I'm not joking with you, Connie. I am unhappy with the way I'm being treated in this hospital. I suspect everyone else who walks into this facility feels the same way. It's not right, and I'm going to do something about it."

"If you need any help, ask me, and I'll be right by your side."

"You got it."

************************

Doctor Rosenstein walked in wearing his scrubs.

"I knew you were good, Allan, but I didn't think you were that good."

"I'm not Ralph. Mr. Canyon stopped me before I could do the resection."

"Then why am I here?"

"Because I told Doctor Coppens to get you."

"What can I do for you Mr. Canyon?"

"Doctor Llewellyn has a problem. You can solve it by repairing the bones in my leg. If you do your job properly, his job becomes easy. End of story."

"Is that it?"

"That's it."

"Let me take-a-peek; and see what we are up against?"

"I don't like the way that small piece of bone is sticking off. I don't believe it is salvageable. Is it okay with you if we change trays?"

"Have fun."

As the surgical trays were changed and the area cleaned. The orthopedic surgeon moved into position to repair the 2 bones. He looked at the x-rays one last time, before he asked for the forceps.

The area was already clamped open as the orthopedist inserted the forceps into the opening. As he looked he noted, that the fibula was going to be the easy one. It would only require a four-inch, surgical steel sleeve, and 'superglue' to keep it in place, until the bone healed itself. This man was lucky, no screws would be needed in this bone.

The tibia, however, was a mess. He reached over with the forceps and tapped the shard that was leaning off to the side, very lightly. It did a 90° turn and was now facing down towards the table. He grabbed it, and took it out without much resistance. He put it into a sterile dish, turned the shard over and looked at the underside. It was diseased to the point it was almost dust.

He looked at Doctor Coppens and said, "Dave will you look at this under the microscope, please?"

"Sure, what do you think we are looking for?"

"French fries."

The Colonel asked, "What are you two playing at?"

"When I'm sure Mr. Canyon, I'll tell you. I am not going to speculate."

"Nurse, I am going to need a 10 inch Sullivan sleeve, silly putty, and short screws."

"Does the manufacturer know that you call their product silly putty?"

"They don't care what I call it, as long as I use it, and they get paid full price."

"Isn't that the truth."

Doctor Coppens asked, "Mr. Canyon when was the last time you had a physical?"

"I don't like questions like that Doctor. However, the answer is 8 months ago. I get a physical every year, whether I want one or not because of that big ape sitting outside. Now tell me what the problem is."

"This is going to be very tough news sir. Should I get him in here?"

"Should I bother getting my leg fixed, or don't I have enough time left?"

"Didn't the physician who did your physical do any blood work on you?"

"I'm going to kill that rotten son of of a bitch."

"Who are we talking about now sir?"

"Get Paul in here now. I want to see the look in his eyes, when you tell me I'm dying."

Paul walked in wearing scrubs 5 minutes later.

"Are we going to Seattle, sir?"

"No, I want you to listen to what these doctors have to say."

"Okay, what's up doctors?"

"Mr. Canyon is very ill."

"Isn't that why he's in the hospital?"

"Mr. Canyon has a disease besides the broken bones, and the crushed artery."

"What is it?"

"Mr. Canyon has a disease called Myoclonal Neuropathy."

With a straight face, Paul asked, "Is that why he broke the bones in his leg?"

"It could be a contributing factor."

"Don't play games with me Sergeant; how long have you known I've had this disease, and what is my prognosis?"

"I've known about it for a little more than six years, sir. You were in late Stage II of the disease, when they finally figured out what it was. If you have progressed at the rate you were going at your last physical, you are in the middle of stage III now.

The oncologists all agreed you were terminal, and unless you were willing to undergo radical treatment, or experimental drugs your prognosis was guarded at best. After doing my due diligence, I decided to let you live out the remainder of your life as the man you are, and not as a test case for radiation, bone marrow transplant, or taking 100 pills a week. That wasn't the man I knew, and I wasn't going to turn you into someone else."

"You didn't think it was important for me to know I was dying."

"Not at all sir. You were deemed terminal. There was no hope of reversal, no cure. I'm sure I could have taken you to these holy places, like Fatima, or Lourdes or that place in South Sudan that says they have the Ark of the Covenant, but I'm not sure which one of us would have started laughing first. Since I was alone, and carried only your reports with me, the oncologists were a little more were more brutal in their terminology of the disease, then Doctor Coppen's was, but the endgame was the same. They called it Plasmacytoma, instead of Monoclonal Neuropathy, but in the end, you are still dead. It is a cancer that forms tumors inside your Bone Marrow. It stops the production of red and white blood cells, as well as bone marrow itself.

It's the tumors that causes the bones to become brittle, and eventually break, because some stupid old man forgets to walk on the ground, instead of on slippery moss covered rocks."

"I resent that remark."

"I don't care what you resent. I'm speaking, and you're on the operating table, so shut up. You have all the other classic genetic markers for this disease, too. (You son of a bitch). You are Male; I had to verify that myself, so I put gloves on when I did it. You are 'Morbidly Obese' 142 pounds for your 5" 6' Height.) You live on the west coast of Vancouver Island, British Columbia, which is the recipient of the radioactive water and debris from the Japanese nuclear plant accident at Fukushima.

You purposely exposed yourself to high doses of radiation. You opened the reactor door to 3-mile Island, Unit 2 to let out heat so the inspectors could go inside an hour later. The only thing you didn't do was put on your radiation suit. When they asked you why, you said it wasn't necessary. You weren't going into the reactor, you were just opening the exterior door. You had just graduated West Point and were still wearing the golden bars of a 2nd lieutenant. By the time you left 3 mile Island, you had the silver bars of a 1st lieutenant on your shoulders, and every commander wanted you. That's when I met you. I had just turned 17 years old, and boy was I in for a rude awakening.

You live a very, very unhealthy lifestyle, since you arrived on the island. You only eat what they make there. Jamaican bakeries six nights a week. Cakes, cookies, breads of every kind. You drink whole milk, and hard liquor to excess. You don't eat meat, you hate fish, and you abhor chicken. You don't eat anything that was grown in the ground, except tomatoes, and that's because we eat Italian food on Sunday."

"How many more lies are you going to tell in this story of yours Paul?"

"Just this 1 more Colonel. As long as you weren't in pain, didn't have kidney failure, weren't suffering from confusion, and your bones weren't breaking daily, I decided to let you live out your life on a day to day basis. After all, sir, you are older than the Himalayas, and something or someone had to kill you, before I did."

"Thank you, Paul; that will be all."

Paul turned on his heel, and walked out of the OR with his back as straight as a steel rod.

Doctor Coppens laughed. "That man is some piece of work."

"That man has protected me for more than 45 years. We have been through things together that few people will ever experience. Fix my leg, I want to go home."

"You're not going home for at least five days, Mr. Canyon, because of the diseased bones. It will take that long for the glue to seep in, and set properly. You will also be in bed, I repeat, in bed, for two weeks after you get home. I take it, if I give that man those instructions, you will follow them."

"I will have no choice. He will break my right leg if I dare get up."

Connie said, "Dammit, I was hoping you would need a private nurse. He is just my type."

"It can be arranged."

"I was just kidding Mr. Canyon. I don't believe my husband, or children would appreciate my taking off with another man."

"They would never find us where I live."

"Where is that?"

"Vancouver Island. I have a tiny residence in the middle of nowhere. It has a few creature comforts. State-of-the-art protection system: visual, infrared, in-ground, and audio. Passive radar displays. Military armaments. A helipad large enough for four full size helicopters. 4 trail bikes, jeeps, and assorted modes of transportation. Electricity, gas, and solar energy. It's close to some gorgeous fishing areas, and hunting is permitted all year round."

"You are that Mr. Canyon? Colonel Lucius Canyon, formerly of the United States Army."

"That's me."

"They tell stories about you and your units on one of those cable channels. They tell about the work you did in the Balkans, Iraq, and South America. They also talk about how the Army threw you out, but the charges were bogus."

"Getting thrown out of the Army was the worst and best day of my life."

"How can it be both?"

"I got to tell the truth in open court about how the United States was getting screwed by the UN and its' member nations, while we were doing all the fighting, and dying.

I was a three-time loser, because of the military way of life. I loved my three wives, but I loved the Army more. It cost me my marriages, which was both a bad thing, and a good thing.

After I was removed from the service, I worked for one man for the rest of my life. He and I are the best of friends, even though we only talk to each other once or twice a year, or in special circumstances, when he needs me for my expertise."

"Who is he, this friend of yours?"

"I will only tell you his code name, because I respect his privacy, as he protects mine. He is known as 'The Private.' He is a board member of every worthwhile charity on this planet. He hasn't taken a salary from any of his companies in over 25 years. The IRS has stopped auditing him because of it. He files his tax returns, as we all do. Many of his companies are public, so he must disclose his income, and benefit packages. Seeing $1.00 and no stock options going to the chairman of the board, makes many people believe that the company is being run very soundly. He doesn't accept health insurance from any of them either, which I found difficult to believe. Then I remembered he owns hospitals all over the world, and I didn't feel so bad for him. He is a wonderful man, and he has a lovely family. However, you don't want to cross him, just as you don't want to cross me. You will pay the ultimate price if you do."

"What about your families Colonel?"

"None of my wives and I were fortunate enough to have children. Paul is my son and heir. He will do great things when I'm gone, because he is a great man. Who do you know that would keep a secret like that from his superior officer, stay by his side every moment, and act like it was just another ordinary day. If I hadn't fallen today, I would never have known I was ill. He would never have told me, until I was deathly ill. Then he would've kept me at the cabin, until the day I died, and buried me with full military honors, after he gathered together every man from my brigade. He will when the time comes. Can we get to work now, I'm getting antsy?"

Doctor Coppen's said, "I'll give you something to take the edge off. Connie, would you give the Colonel 8 mg of Propofol please."

"8 mg of Propofol."

"Mr. Canyon, you're going to feel a burning sensation in your hand, right about now."

"Am I going to fall asleep?"

"Yes, you are."

"Get Paul in here on the double. I do not want you to hear any National Defense secrets. They could shorten your lives considerably."

Connie didn't wait to be asked. She flew out of the OR, and into the surgical waiting room. She grabbed Paul, pulled him into the anteroom of the operating room, told him to wash, get greens on, walk through the operating room doors, and stand there until she put gloves on him.

Paul didn't ask why, he knew the drill.

By the time he reached the Colonel's side, he was unconscious.

"Did he say anything at all?"

The three doctors said, "NO," in stereo."

"Don't lie to me, I may be able to save your lives, if I know what he said."

Doctor Llewellyn chimed in.

"Your friend has only been asleep for a minute. He has not uttered a word."

"May I have two towels please."

They were handed to him without delay.

"Please continue with your work, and if I might say so, do it perfectly, because your lives depend on it. I may kill this old man. I have earned the right to do so. However, if he dies because any of you screws up, I will find out which one it was, and you will not like the way I terminate your life. I know how to do an autopsy. I've done many of them during my time in the Army. I've even done some on living patients, so don't fuck with me. Do your jobs, and do them as if your lives depend on it, because they do."